Antispasmodic medications may be associated with reduced recovery during inpatient rehabilitation after traumatic spinal cord injury

Model System:

TBI

Reference Type:

Journal

Accession No.:

J78585

Journal:

Journal of Spinal Cord Medicine - JSCM (formerly Journal of the American Paraplegia Society)

Year, Volume, Issue, Page(s):

2018 , 41, 1, 63-71

Publication Website:

Abstract:

Study investigated whether antispasmodic medications are associated with neurological and functional outcomes during the first year after traumatic spinal cord injury (SCI). A retrospective analysis was conducted of data collected prospectively from six inpatient SCI rehabilitation centers. Baseline-adjusted outcomes at discharge and one-year follow-up were compared using analysis of covariance between patients who received antispasmodic medication on at least 5 days during inpatient rehabilitation and patients who did not. Outcome measures included the Rasch-transformed motor subscore of the Functional Independence Measure (FIM) and the International Standards for Neurological Classification of Spinal Cord Injury motor scores, grade, and level. Of 1,259 included patients, 59.8, 35.4, and 4.8 percent were injured at the cervical, thoracic, and lumbosacral levels, respectively; 65.6 percent had motor complete injury. Rasch-transformed motor FIM score at admission averaged 23.3. Total motor score averaged 39.2. Six hundred eighty-five patients (54.4 percent) received one or more antispasmodic medications on at least 5 days. After controlling for demographic and injury variables at admission, Rasch-transformed motor FIM scores at discharge were significantly lower in patients receiving antispasmodic medications than in those who did not. This trend persisted in secondary analyses for cervical, thoracic, and lumbosacral subgroups. Multivariate regression showed that receiving antispasmodic medication significantly contributed to discharge motor FIM outcome. At one-year follow-up, no outcomes significantly differed between patients ON or OFF antispasmodics. Findings suggest antispasmodic medications may be associated with decreased functional recovery at discharge from inpatient traumatic SCI rehabilitation. Randomized prospective studies are needed to directly evaluate the effects of antispasmodic medication on recovery.

Author(s):

Theriault, Eric R., Huang, Vincent, Whiteneck, Gale, Dijkers, Marcel P., Harel, Noam Y.